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慢性髓性白血病患者合并结核病:基于文献综述的治疗建议

Association of tuberculosis in patients with chronic myeloid leukemia: a treatment proposal based on literature review.

作者信息

Iqbal Phool, Soliman Ashraf, De Sanctis Vincenzo, Yassin Mohamed A

机构信息

Department of Internal Medicine, Hamad Medical Corporation, (HMC), Doha, Qatar.

Pediatrics and Endocrinology Department of Pediatrics, Hamad Medical Center, Doha, Qatar.

出版信息

Expert Rev Hematol. 2021 Feb;14(2):211-217. doi: 10.1080/17474086.2021.1875818. Epub 2021 Jan 21.

Abstract

: Chronic Myeloid leukemia (CML) is one of the first hematological malignancy linked with genetic alterations and have a targeted therapy with Tyrosine Kinase Inhibitors. However, there are certain unanswered questions and many unmet needs which limit its treatment. Concurrent Mycobacterium Tuberculosis (Mtb) infection is one of those significant factors. Tuberculosis (TB) is a highly prevalent disease in association with diabetes mellitus, malignancy, poor socioeconomic environment, HIV, and other immunosuppressive conditions in developed and developing countries. Anti-TB medications can affect other drug's pharmacokinetics by altering liver enzymes metabolism and poses treatment challenge with CML medications.: The authors performed a rigorous literature review between 2000 and 2020 using PubMed and Google Scholar, with the main focus on all articles addressing the topic of TB in CML. Authors highlighted the need to improve clinical diagnosis and to define management strategy for this dilemma.: In the current era, there are no clear guidelines or recommendations in the literature that address this problem. The aim of this review was to collect and carefully analyze the literature to highlight the need for comprehensive guidelines and propose an algorithm for better management of TB in patients with CML.

摘要

慢性髓系白血病(CML)是最早与基因改变相关的血液系统恶性肿瘤之一,并有酪氨酸激酶抑制剂的靶向治疗方法。然而,仍存在一些未解决的问题和许多未满足的需求限制了其治疗。同时合并结核分枝杆菌(Mtb)感染是其中一个重要因素。结核病(TB)在发达国家和发展中国家与糖尿病、恶性肿瘤、社会经济环境差、艾滋病毒及其他免疫抑制状况相关,是一种高度流行的疾病。抗结核药物可通过改变肝酶代谢影响其他药物的药代动力学,给CML药物治疗带来挑战。作者在2000年至2020年间使用PubMed和谷歌学术进行了严格的文献综述,主要关注所有涉及CML中TB主题的文章。作者强调了改善临床诊断以及为这一困境确定管理策略的必要性。在当前时代,文献中没有明确的指南或建议来解决这个问题。本综述的目的是收集并仔细分析文献,以突出制定全面指南的必要性,并提出一种算法以更好地管理CML患者的结核病。

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